Retinal haemorrhage is bleeding within or beneath the retinal layers. It is a sign rather than a diagnosis and has many potential causes.
Causes and patterns
Location and shape of haemorrhages give diagnostic clues.
- Dot-and-blot haemorrhages in diabetic or hypertensive retinopathy
- Flame-shaped haemorrhages in nerve fibre layer from vascular or pressure changes
- Preretinal or subhyaloid haemorrhages from trauma, Valsalva, or vein occlusion
- Associated systemic conditions include blood dyscrasias and infection
Management
Treatment targets the underlying cause and monitors for complications.
- Full ocular and systemic work-up, often including blood pressure and laboratory tests
- Observation for small, stable haemorrhages
- Laser, injections, or surgery for cases with macular involvement or neovascularisation
- Urgent review if haemorrhage is sudden with severe vision loss or trauma history
